Outsmart Cervical Cancer with Paps, Vaccines
Outsmart
Cervical Cancer with Paps, Vaccines
by Darra McMullen,
Women’s Health Network
Writer/Researcher
Author’s Note: Due to December’s “holiday crush”, the
planned input from a cervical cancer expert could not be arranged until later
in January. The results of that
interview will be made available ASAP, but for now, please enjoy the following
article, which contains a lot of relevant, useful, basic cervical cancer
information. The article originally
appeared just a few years ago on the GHWCC website; the information is still
accurate and helpful, and if you missed the article the first time around, you
now have a second chance to review it while we wait to hear the latest news
from a cervical cancer expert – coming soon.
Cervical
cancer is now much less common in the United States than it used to be just a
few decades ago, and we can all thank the invention of the Pap test and
American women’s adherence to frequent testing for that decline in cervical
cancer rates. Still, to keep this awful
disease’s rate of occurrence on a steady downward slide, there are some basic
facts about the disease and its prevention that we should all understand.
To begin, the cervix is the lower
part of the uterus that connects the main body of the uterus to the vagina. Almost always, cervical cancer is caused by a
virus known as HPV. There are a few rare exceptions where the cause of the
cervical cancer is unclear, but the vast majority of cervical cancer cases are
linked to HPV infection. HPV is an
abbreviation for human papilloma virus, of which there are more than 100
related types. About 60 types are found
on the skin and can cause the common wart with which we’re all familiar. The remaining 40+ types of HPV are called
genital HPV because they affect the anal and genital areas only, not other skin
areas, such as on the hands or feet.
These roughly 40 types of genital
HPV are divided into two groups called “low-risk” and “high-risk” HPV. “Low-risk” genital HPV causes genital warts
and can even cause changes in cervix cells, but not changes that lead to
cancer. “High-risk” HPV, on the other
hand, has been linked with genital or anal cancers in both women and men. It is these “high-risk” HPV viruses that
cause cervix cell changes that lead to pre-cancers or cancer.
Fortunately, much can be done with
regard to early detection of the disease, treatment, and prevention of
infection in the first place. Let’s
start with how HPV is contracted. According
to the American Cancer Society, “Genital HPV is passed from one person to
another by direct skin-to-skin contact during vaginal, oral, or anal sex. It is not spread through blood or body
fluids.” Genital HPV is very common;
approximately 50% to 75% of people who have ever had sex will get HPV at some
time during their lives. Certain
estimates name a rate as high as 80% of sexually experienced individuals are
expected to contract some form of HPV.
Yet, comparatively few people go on to develop cancer. The reason for this low rate is
two-fold. Not all HPV infections are of
the type to cause cancer. Also, the
human body tends to clear the virus over time.
Usually, from six months to two years after contracting HPV, the human
body succeeds in extinguishing the infection; and therefore, the HPV viruses
that can cause pre-cancerous cells to form never have a chance to spread or
cause problems.
For the relatively small percentage
of women (about 10%) who don’t clear the virus from their bodies naturally over
time, they may find themselves at higher risk for pre-cancerous cell
formation. Still, not every woman who
has detectable levels of HPV over several years will go on to develop
pre-cancerous or cancerous cells. Some
individuals seem to be able to live with HPV and suffer few effects.
For those women who do develop pre-cancerous
or cancerous cell changes, there are a number of treatment options available,
which are often quite effective and lifesaving.
The key to successful treatment is to discover the pre-cancerous or
cancerous cells early in their development.
Pre-cancerous cells, if destroyed at this early stage, will never
develop into actual cancer. Similarly,
early stage cancerous tumors are much more successfully treated than those in
later stages.
With early detection of problem
cells so vital to positive outcomes, in steps the need for regular Pap tests,
which provide that essential information.
Between 1955 and 1992, cervical cancer death rates declined by nearly
70%. The primary reason for the change
was the increased use of the Pap test.
In more recent years, the death rate from cervical cancer continues to
decline by about 3% per year for American women. The Pap test has been a huge
help in the fight against cervical cancer.
Although the Pap test is a wonderful
means of identifying problem cells, even the Pap has its limitations. For one thing, the test is interpreted by
humans, who can mistakes. Also, a number
of other factors can make the chances of obtaining an accurate result less
likely. To increase the likelihood of
catching problem cells early, the American Cancer Society makes the following
recommendations:
•All women should begin getting Pap
tests three years after they start having vaginal intercourse. A woman who waits until after age 18 to have
sex should begin screening by age 21. Pap
tests should be performed every year until age 30. Women with no exceptional risk factors who
have had three normal Pap test results in a row by age 30 may then be tested
less often, generally every two to three years.
Women who have exceptional risk factors, such as HIV (AIDs virus), other
cancers, or a weakened immune system from other causes should continue to get
Pap tests yearly.
•Women age 70 and older who have had
three or more normal Pap results in a row can choose to stop screening
altogether unless they fall into a high risk factor group due to other health
conditions. Women are urged to consult
their doctors about their individual health situations before electing to cease
testing.
•Women who have undergone a total
hysterectomy, including removal of the cervix, may also cease Pap testing,
unless the reason for removing the cervix was because of pre-cancer or cancer
formation. If so, those women are
advised to consult their doctors about appropriate screening for the
possibility of future cancer risk in other areas of the body.
To help
reduce the number of factors that can cause an inaccurate Pap reading, always
do the following prior to the actual Pap test:
•Don’t schedule the appointment
during a menstrual period.
•Don’t have sexual intercourse for
48 hours before the test.
•Don’t douche, use tampons, birth
control foams, jellies, or other vaginal creams or vaginal medicines for 48
hours before the test.
Besides frequent screenings (Pap
tests), there is another way to help prevent cervical cancer - vaccination,
which can prevent becoming infected with two types of HPV that most often cause
cervical cancer. Vaccination with either
Gardasil or Cervarix, which are vaccines designed to protect the previously
unexposed person from ever contracting HPV, can be helpful. These vaccines are generally recommended for
people who are not yet sexually active, and therefore, highly unlikely to have
been exposed to any HPV viruses. Girls
and young women, ages 9 to 26 years, are urged to consider getting vaccinated
by the American Cancer Society. Boys and
young men, aged 9 - 26, are also eligible for vaccination. Males can get cancers of the head, neck,
anus, and penis from HPV, as well as genital warts; therefore, HPV viruses do
pose a threat to males as well. There is
evidence that vaccination provides at least some protection, perhaps quite a
bit, to males for both cancer protection and genital warts. Gardasil also contains protection against the
two types of HPV that cause most genital warts (about 90%) in both males and
females.
There are some downsides to
vaccination, which should be considered before making a final decision to
vaccinate. There is a greater than
normal (as compared to other types of vaccines) risk of fainting immediately after
receiving the injection. Because of this
risk, there is a mandatory waiting period of 15 minutes after receiving the
shot before patients are allowed to leave.
Although most patients recover from a fainting spell with no further
problems, some scattered individual accounts have complained of other side
effects well after the injection was received.
Individuals with multiple allergies,
especially to yeast, should consult their doctors before deciding to proceed
with vaccination. Likewise, individuals
who have histories of medical difficulty with vaccines in general should
consult their doctors before proceeding.
Anyone who has had a bad experience with the first shot (in the series
of three) for HPV should not receive additional HPV vaccinations.
Another issue to consider with HPV
vaccination is the cost. Always check with your insurance company or state or
federal health authorities about your individual options before proceeding
uninformed.
Possible vaccination benefits to
older males and females, from ages 27 and up, are being studied. Although most
people have generally been exposed to HPV by this age, there is reason to
believe that vaccination, even after virus exposure, may somehow help prevent
the virus from causing troublesome cellular changes in the body.
Whether young or older, all women
should remain vigilant with Pap test screening.
Even HPV vaccinated young women should still get regular Pap tests. The vaccine can help prevent only about 70%
of cervical cancer risk. There’s still
that 30% risk lurking out there for the vaccinated group and a greater risk
than that for the unvaccinated.
Early detection is a lifesaver;
always make use of your friend, the Pap.
